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Anatomy

Upper Limb

Question 135 of 239

You have been asked to teach a group of medical students about hand injuries. You cover some anatomical principles including blood supply to the hand. Regarding the palmar arches, which of the following statements is CORRECT:

Answer:

The deep palmar arch usually lies proximal to the superficial palmar arch.

Palmar Arches

Anatomy / Upper Limb / Wrist and Hand

Last Updated: 10th April 2019

There are two palmar arches which supply the hand. Laceration to the palmar arches results in profuse bleeding.

Superficial Palmar Arch

The ulnar artery forms the superficial palmar arch which communicates laterally with a palmar branch of the radial artery. The superficial palmar arch lies superficial to the long flexor tendons of the digits and just deep to the palmar aponeurosis. It is located across the centre of the palm, about level with the distal border of the extended thumb.

Deep Palmar Arch

The radial artery forms the deep palmar arch which communicates medially with the deep palmar branch of the ulnar artery. The deep palmar arch lies between the metacarpal bones and the long flexor tendons of the digits. It is located approximately 1 cm proximal to the superficial palmar arch.

By Rhcastilhos (Gray1237.png) [Public domain], via Wikimedia Commons

Palmar Arches. (Image by Rhcastilhos (Gray1237.png) [Public domain], via Wikimedia Commons)

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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